Long-term weight change after oesophageal cancer surgery

Abstract

Background: Malnutrition is common after oesophageal cancer surgery. This study investigated weight changes and the risk of malnutrition among long-term survivors. Methods: A nationwide cohort study was conducted in Sweden in 2001-2004, with follow-up to 2008. Weight was assessed before oesophagectomy, after 6 months and at 3 years. Logistic regression was performed with adjustment for confounders. Odds ratios (ORs) for postoperative weight loss of at least 15 per cent were estimated. Results: Some 203 patients survived at least 3 years after oesophagectomy. Continuous weight loss occurred for up to 3 years. Women and men had a similar risk of malnutrition after 3 years (OR 0.85 (95 per cent confidence interval 0.24 to 2.98)). In overweight patients (preoperative body mass index at least 25 kg/m2) the risk of malnutrition was increased almost fivefold at 6 months (OR 4.90 (2.27 to 10.59)) and 3 years (OR 4.60 (1.80 to 11.78)). There was no difference in weight loss at 6 months between survivors and those who died between 6 months and 3 years after surgery (OR 1.11 (0.64 to 1.94)). Conclusion: Weight loss can be long lasting after oesophagectomy; overweight patients are at particularly increased risk of malnutrition. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.